[Digital health applications for depressive disorders in Germany : A narrative review of the evidence and integration into treatment].

Background: Digital technologies open up new opportunities in the treatment of mental health disorders. Internet-based and mobile telephone-based interventions (IMIs), in particular, have proven to be effective, cost-efficient and accessible approaches to improving the care of people with mental disorders. In Germany digital health applications (DiGAs) that are reimbursed by all public health insurances are gaining increasing importance in routine clinical practice.

Objective: This article provides a narrative review of the evidence and challenges related to DiGAs for depression in the German healthcare system. The approved DiGAs are presented and key studies, developments and perspectives for future research and care concepts are discussed.

Material and methods: This study is based on a narrative review of the relevant literature. The focus is on evidence-based DiGAs approved by the Federal Institute for Drugs and Medical Devices (BfArM) for the treatment of depression and their integration into routine care as well as acceptance by patients and clinicians.

Results: Internet-based cognitive behavioral therapy (iCBT) in particular, demonstrate a small to medium effect strength for depression, comparable to face-to-face therapy (Hedge's g = 0.43). Guided and blended care approaches appear to provide advantages with respect to the evidence and care; however, the utilization of DiGAs remains low, considering the large number of affected individuals, which is attributable to factors, such as limited awareness, complex access routes and prescription processes and data privacy concerns.

Conclusion: Despite promising evidence, the integration of DiGAs into existing healthcare systems remains challenging. Future research efforts should focus on the long-term effectiveness, personalization of digital solutions and hybrid care models to enhance acceptance and utilization.